Person 1 – “I’m sorry.”
Person 2 – “No you’re not. You don’t really mean it.”
Person 1 – “I said I was sorry, and I meant it. I was wrong.”
Person 2 – “We’ll see. I don’t really believe you.”
We have all had conversations like the above. Our relationship with someone has sustained some sort of rupture and is in desperate need of repair. If we are honest, these exchanges are difficult but so necessary.
I have become acutely aware over the last decade of the importance of relational health. As a physician, I concentrated on physical health, mental health and even behavioral health. But relational health was on the back burner. It seemed to be a side light, a consequence of regular social exchanges, and largely uncontrollable. Relational health would just be something to remark about but not feel you could have much of an impact in trying to improve it.
Well, relational health is now recognized as being critical to our health and well-being. The work of Dr. Bruce Perry notes it be so important, my recent book with Dr. Andy Garner supports it, and the American Academy of Pediatrics has established a National Center for Relational Health and Trauma-Informed Care.1-3
Relational health can be aptly described with 3 components that are constantly in motion. These components are crucial to the safe, stable, nurturing relationships that define our ability to provide for our children and our families and our communities.4 Let’s review them –
- Relate. As expressed by Dr. Bruce Perry in the Foreword of Thinking Developmentally, “the central role of safe, stable, nurturing relationships is at the core of healthy families, communities, and societies. We don’t need more data to center this primary principle of thinking developmentally in our caregiving, educational, and health policy, programs and practice.”2(p. xiv) Not only do relationships matter to dampen and ameliorate adverse childhood experiences (ACEs), we now know that positive childhood experiences (PCEs) can buffer and overcome ACEs and, in the absence of ACEs, promote flourishing to an even greater degree.5 In the active state of relating, we demonstrate “an ability to accurately predict each other’s thoughts, emotions and behaviors; understanding while being understood.”2 (p. 31) These abilities should be our aspirations. Our biology requires relationship building at all levels – parent/child, parent/grandparent, sib/sib, spouse/spouse, teacher/pupil, citizen/citizen, leader/citizen, family member/family member, and on and on.
- Rupture. Yet, life is not perfect. Problems or difficult issues will arise. They might be minor distractions (the phone ringing, the TV) or major disagreements that are real or blown out of proportion. At their core, these ruptures are due to “an inability to accurately predict each other’s thoughts, emotions, or behaviors [demonstrating frustrations at] not understanding or not being understood.”2(p.31) Ruptures are inevitable. Their consequences are not. So, the key will be in the repair.
- Repair. Our ability to handle adversity (and we all have faced and will face adversity) is in the repair of the rupture at hand. We should be seeking to “restore accurate predictions of each other’s thoughts, emotions, and behaviors; a return to understanding while being understood.”2(p.31) Granted, repair is often very difficult. It is usually predicated on the need for extending and accepting forgiveness.6 The opening lines to this blog post demonstrate the difficulty at hand. One or both parties might need to apologize. One and eventually both parties will need to regulate so they can reaffirm the importance of their relationship.7 This latter process is not like an on-off light switch. It can be more like a variable light switch adjusting to different intensities as the process proceeds. It is only when regulation sets in that trust can be reestablished, distress levels reduced, learning occur, and reentry into the relating phase take place. Ah, the joy of reentry!
I hope that I have emphasized the cyclic nature of our relationships. We will relate. We will rupture the relationship. We can then repair the rupture so we can relate again. Hence, like hair shampooing, we enter a cycle. Wet hair, lather shampoo, rinse and repeat. Once we recognize the need to be present, attentive, attuned and responsive in our relationships, perhaps we can strengthen our relationships, reduce the ruptures, and do better with repair.
I encourage the interested reader to click on the video link noted to see a brief discussion about the beauty of presence and how it affects our relationships.8 This beauty can meld into our repair processes after we sustain a rupture. We have had ruptures, we do have ruptures, and we will have ruptures in our relationships. Repair is the key.
Relate – Rupture – Repair. Repeat. This cycle should get better over time as we consciously seek to build new relationships and to sustain and enhance existing relationships. We should always be prepared to Relate (while regulated) – (deal with the inevitable) Rupture – (actively) Repair. Only then can we build up the trust needed for love and understanding.
- Perry B, Winfrey O. What Happened to You? Conversations on Trauma, Resilience and Healing. Flatiron Books; 2021. 304 pp
- Garner A, Saul R. Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health, 2nd American Academy of Pediatrics; 2025. 200 pp.
- https://www.aap.org/en/patient-care/national-center-for-relational-health-and-trauma-informed-care/
- https://mychildrenschildren.com/my-three-moms-and-ssnrs/
- https://mychildrenschildren.com/positive-childhood-experiences/
- https://mychildrenschildren.com/forgiveness-is-so-hard/
- https://mychildrenschildren.com/legos-why-regulation/
- https://vimeo.com/1088743504?share=copy